膝关节镜治疗重度髌股关节炎疗效分析

发布时间：2018-03-21 22:21

  本文选题：去神经化治疗　切入点：髌股　出处：《南昌大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:探讨关节镜下髌股关节去神经化治疗重度髌股关节炎的效果,以此来促进临床治疗。方法:回顾我们对2012年1月至2016年1月在我院就诊的44例以膝前痛为主诉,上下楼梯和蹲起时疼痛更为明显的患者,男性患者18例,女性患者26例,年龄49-68岁,平均年龄58.7岁,平均病程2.8年,在获得患者同意情况下对患者进行髌股关节下清理+微骨折+髌骨成形+外侧支持带松解+髌股关节周围去神经化手术及术后随访分析,术前、术后6个月分别行FELLER髌骨评分、Lysholm评分、Kujala膝关节评分标准,行股骨肌肉群肌电图检查并拍摄髌骨轴位片,与术前进行比较,评估髌骨轨迹纠正情况。观察有无髌骨内侧脱位及反射性神经营养不良和缺血坏死等并发症发生,并统计患者的临床疗效和股骨肌肉群活动时表面肌电测试。计量资料组间比较采用t检验,组内比较采用配对t检验,计数资料采用2?检验,P0.05为差异有统计学意义。结果:术后平均随访16.5个月,术后无感染或神经、血管损伤、髌骨内侧脱位等并发症发生。术前、术后均采用FELLER髌骨评分、Lysholm评分、Kujala膝关节评分标准,手术前后评分差异有统计学意义P≤0.05。在研究组股骨肌肉群活动时表面肌电测试中有43例患者都取得了效果,拥有97.73%的总有效率,与术前比较差异有统计学意义(P0.05)。结论:我们通过关节镜下髌股关节去神经化治疗,髌骨成形和外侧支持带松解,能明显缓解并改善患者症状,达到治疗目的。
[Abstract]:Objective: to investigate the effect of arthroscopic denervation of patellofemoral joint in the treatment of severe patellofemoral arthritis. Methods: from January 2012 to January 2016, 44 patients with anterior knee pain were reviewed. There were 18 male patients and 26 female patients, aged 49-68 years, with an average age of 58.7 years and an average duration of 2.8 years. The patients were treated with subpatellofemoral debridement with the consent of the patients. The lateral retinaculum of patelloplasty was loosened around patellofemoral joint and followed up before operation. Six months after operation, FELLER patella score and Lysholm score and Kujala knee joint scoring standard were performed respectively. The femur muscle group electromyography was performed and patellar axial radiographs were taken, and the results were compared with those before operation. To evaluate the correction of patellar locus and to observe the occurrence of complications such as medial dislocation of patella, reflex neurodystrophy and ischemic necrosis. The clinical efficacy and surface electromyography of femur muscle group were measured. T test was used to compare measurement data, matched t test was used for intragroup comparison, and 2? Results: there was no infection, nerve, vascular injury, medial dislocation of patella and other complications after operation for an average of 16.5 months. FELLER patella score and Lysholm score and Kujala knee scoring standard were used after operation. There was a significant difference before and after operation (P 鈮，

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